How well do type 2s tolerate carbs?

[rosserk]

Eating normal carbs before the OGTT doesn't mean just the day before, it means for 2 or 3 or 4 days before. Doing that, your pancreas has plenty of time to adjust. Then at the test it gets hit by a large shot of glucose, usually Lucozade, to see what the reaction to that is. A diabetic will react because the pancreas can't cope with the extra glucose in one shot. The actual test is a fasting one, so before the Lucozade there is no food in your system.

I understand that but I'm not understanding the reasoning behind the diet surely a normal functioning pancreas will respond accordingly regardless of what you've eaten in the days, weeks before. Isn't that the point? Sorry I'm not saying you're wrong just trying to understand it..

 

[rosserk]

The OGTT is a test that shows how high your bg is 2 hours after ingesting a set amount of glucose. Nothing misleading about that.

An OGTT is a diagnostic tool used by the NHS, under standard conditions (one of these conditions is that the patient has been eating a 'normal' diet containing carbs). Unless the standard conditions are met, the test results are useless because they will not conform to the NHS's diagnostic standards.

For this reason, I have declined an OGTT for the last three years.
And because I have declined the test, and because my HbA1c is controlled and below the level the NHS considers to be diabetic, my doctor will not diagnose me as Type 2.

With the NHS, you play the game, or you don't. There are consequences to each choice.

I understand everything you're saying. My point is the way someone can manipulate the pancreas? Is someone diabetic or have they been messing around with their pancreas. I.e. Stopping the production of insulin by low carbing? That is what's being said the less carbs you eat the less insulin you produce? Something's not making sense to me but does bring me back to why a doctor would advise against low carbing, if you can train your insulin response by low carbing?

 

[Brunneria]

Even a perfectly normal (non glucose tolerance impaired individual) will have reduced insulin production after they have adjusted to a low carb diet. This happens to everyone, and is nothing to do with being diabetic.

Equally, a few days of eating carbs regularly will cause anyone's pancreas to return to a higher level of insulin production (unless they have lost the ability to do so through beta cell damage).

The difference between a diabetic and a non-diabetic is that their insulin production is insufficient to keep blood glucose within normal levels while on a 'normal' carb diet.

 

[andcol]

From my perspective I get a rise of 3 from 30g or 300g. I find my digestive system controls the release in combination with the rate of absorption. However I do see initial peaks higher or lower depending on the carb composition and my previous meals

 

[andcol]

The pancreas has a 2 phase approach to dealing the glucose. Phase 1 is a dump of insulin to deal with the peak and this is a learnt behaviour from previous meals. Phase 2 is the normal release to bring you down into normality and continually process what is being released by the digestive system. So with t2 the phase 1 insulin cannot handle the peak pushing you too high (this will happen to a norm if they eat too much unexpectedly] and then the phase 2 insulin is ignore until levels are really high due to insulin resistance.

Now low carving works to reduce the phase 1 and 2 requirements. Not that lchf can also make it look like insulin resistance due to the learning nature of the pancreas

 

[CollieBoy]

The pancreas has a 2 phase approach to dealing the glucose. Phase 1 is a dump of insulin to deal with the peak and this is a learnt behaviour from previous meals. Phase 2 is the normal release to bring you down into normality and continually process what is being released by the digestive system. So with t2 the phase 1 insulin cannot handle the peak pushing you too high (this will happen to a norm if they eat too much unexpectedly] and then the phase 2 insulin is ignore until levels are really high due to insulin resistance.

Now low carving works to reduce the phase 1 and 2 requirements. Not that lchf can also make it look like insulin resistance due to the learning nature of the pancreas

I have found that my phase 1 is totally shot, but my phase 2 kicks in an I peak at ~50minutes andI have returned to at/below fasting levels well within the 2hr of the OGTT
BTW neither my GP or hospital have warned me to "carb up" in the 2-3 days prior to the OGTT (Luckily I knew)

 

[rosserk]

The pancreas has a 2 phase approach to dealing the glucose. Phase 1 is a dump of insulin to deal with the peak and this is a learnt behaviour from previous meals. Phase 2 is the normal release to bring you down into normality and continually process what is being released by the digestive system. So with t2 the phase 1 insulin cannot handle the peak pushing you too high (this will happen to a norm if they eat too much unexpectedly] and then the phase 2 insulin is ignore until levels are really high due to insulin resistance.

Now low carving works to reduce the phase 1 and 2 requirements. Not that lchf can also make it look like insulin resistance due to the learning nature of the pancreas

From your prospective then, someone unaccustomed to high carb meals could have taught the pancreas not to respond with insulin which would result in high blood glucose readings? So your saying low carbing reduces the requirement for insulin (my understanding) and not low carbing reduces the amount of insulin produced?

 

[rosserk]

I have found that my phase 1 is totally shot, but my phase 2 kicks in an I peak at ~50minutes andI have returned to at/below fasting levels well within the 2hr of the OGTT
BTW neither my GP or hospital have warned me to "carb up" in the 2-3 days prior to the OGTT (Luckily I knew)

I was under the impression that as long as your phase two insulin response cleared the raised glucose levels within two hours you could not be labelled diabetic? Clearly not the case.

 

[rosserk]

From my perspective I get a rise of 3 from 30g or 300g. I find my digestive system controls the release in combination with the rate of absorption. However I do see initial peaks higher or lower depending on the carb composition and my previous meals

Thanks for answering my original question. I seem to have taken people off on a tangent! Lol

 

[andcol]

I was under the impression that as long as your phase two insulin response cleared the raised glucose levels within two hours you could not be labelled diabetic? Clearly not the case.

There is a additional thing that they look for - you should never go over 11.4 (or around there) is you are not diabetic.

From your prospective then, someone unaccustomed to high carb meals could have taught the pancreas not to respond with insulin which would result in high blood glucose readings? So your saying low carbing reduces the requirement for insulin (my understanding) and not low carbing reduces the amount of insulin produced?

well actually it does both but if you stop low carbing after a few days you produce more insulin. The reduction in insulin production isnt permanent but is measurable at the time. The body gets sluggish in its reaction to carbs because it learns that the release into the body will be slow/small and gradual. As an example my fasting level is generally 0.5 to 0.2 mmol/l lower when I am high carbing and that is caused by my body reacting to the liver releases faster.

 

[CollieBoy]

There is a additional thing that they look for - you should never go over 11.4 (or around there) is you are not diabetic.

In my case they would never know!
At GP/Hospital, it's fasting level, +2hr level. No +1hr or intermediate BG tests!
(I monitored by finger-pricks and only got to 10.)

 

[purplepenguin]

For me I can barely touch carbs without going sky high. I am following Dr Bernstein's method and stick to 6g at breakfast and 12g at lunch and dinner. Any more than that seems to adversely affect me. I am only a week and a half into it though so things may change as my body gets used to lower levels.